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Old 07-08-2013, 02:52 PM
twowheelyankee twowheelyankee is offline
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Join Date: Apr 2013
Posts: 28
Default Won my Appeal with BCBS-TX Now TBI Drops BCBS

So after months of dealing with BCBS of Texas, I won my appeal to have a one level lumbar covered. While I was planning on my surgery in the October time frame, I received a letter and a phone call indicating Dr. Guyer (and presumably Texas back Institute) would be dropping BCBS because they don't pay enough. Therefore, I would need to have my surgery before August 1 (When in fact they actually cut ties with BCBS). So all of my post surgery care would now be out of network. I was told I was the second to win a BCBS appeal so how can they be losing money?

I made an appointment with Dr. Guyer for a follow-up consultation and to get some further info. After waiting in the office for 45 minutes without a peep from the staff or doctor, I walked out. TBI does not have a quality staff and the doctors truly do not care about their patients. This might be a general statement, but I have never waited less then 45 minutes for any of my appointments, have to call and email 2 or 3 times to get an answer from the staff.

Through conservative measures I have gotten my back to a point where surgery is not immediately needed, but will be in the future.

Take this with a grain of salt...... May not be reflective of all patients, but it is reflective of my care under Guyer and TBI.

-- Jim
__________________
8 mm A-P herniation with annular tear at L4/L5
Initial Injury 2004
Chiro, 14+ Epidural Injections, PT
ADR insurance appeal won in 2013, delayed surgery
2016 pain is now affecting quality of life. Contemplating ADR surgery again.

2016 delayed surgery again due to successful pain management with meds.
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